Q and A

Question

Can partying explain my viral load increase?

Hi

I have been on medications for about 2 years. I am on atazanavir, ritonavir and truvada. I have been undetectable for about 1.8 years and my CD4 is 900, but a blood test taken last week returned a viral load 3,560.

I have been called by my clinic this morning to come in for a new blood test which i did this afternoon. I had the impression that the nurse were worried and I am terrified now. I will have to wait another week to see if I ll be fine. They said that such a result can’t be a blip.

How can a result of viral load 3,560 return to undetectable within 7 days?

Do you think that because I have been partying and took some recreational drugs few days before my blood test, it could have affected my viral load?

Answer

Hi

Thanks for your question and the chance ot post the answer online.

For your personal situation, first get the test confirmed. Laboratory errors, including wrong labeling or mixed samples can explain unexpected results. So the confirmed test will check this is your sample.

Blips are defined differently. They are usually defined as increasing from less than 50 copies to over 200-300 copies/mL. However, I have heard of blips over 2,000 copies/mL that were undetectable on the next test.

Recreational drug use should not have any direct influence on viral load, unless it affected your adherence, and you were late with or missed some of your meds. If you were adherent, and none of the reasons listed below are related, then the partying itself would not be an explanation.

As long as adherence is good, it is very rare for someone whose viral load has been undetectable for over a year to have rebound in viral. In the UK this is less than 5% of people each year.

Reasons for this include:

  • Missing or being late with medication. Strict adherence is always important.
  • Drug interactions with other medications. Does your doctor or HIV pharmacist know about all the drugs and medications you use?
  • Poor drug absorption. Do you have other health problems. for example, diarrhoea.
  • Other infections. Infections that activates the immune system, sometimes causes HIV viral load to increase – for example, flu, vaccinations, or some other sexually transmitted infections.

If the viral load is confirmed at a similar or higher level, your doctor will probably discuss the options for changing treatment. You should also have a resistance test whenever viral load is confirmed over 500-1000 copies/mL when on treatment to inform this choice.

48 comments

  1. Simon Collins

    Hi Thuliza, thanks, it sounds like you are doing very well on treatment. So long as your viral load is undetectable when you come to give birth, having a natural delivery is usually recommended. If your viral load is undetectable, it is also okay to breastfeed your baby, but please talk with your doctor about these questions. I am sorry that i-Base doesn’t have details of services in South Africa, but asking the hospital or local HIV organisation might be a good way to find out. Good luck with everything.

  2. Thuliza

    Hi, I hv been on ARV medication since June 2017 when I was 10 weeks pregnant.I am now 29 weeks, Is it possible for me to deliver natural and breastfeed my baby.baby . What are the implications based on that?

    Also where to get free counselling in south africa, gauteng coz my medical funds are exhausted to cover that.

  3. Lisa Thorley

    Hi Milan,

    Drinking coffee will not influence your viral load. Therefore, you should have this checked again. It may be a blip, or it could be an indication that there is a problem with your meds. Are you taking them as prescribed?

  4. Milan

    My viral load was undetectable, I started to drink coffee for weight control, now my viral load is 583. Is coffee the problem?

  5. Lisa Thorley

    Hi Miriam,

    Before I can help you, I’ll need to know how long you’ve been on meds for.

  6. Miriam

    Hi…please kindly assist me my viral load is 300copies and yet my adherence is good.I take my drugs on time…please help me.

  7. Lisa Thorley

    Hi Patrica,

    Please see the following:

    http://i-base.info/qa/4669

  8. Patricia

    How long it takes for viral load to be unditectable

  9. Lisa Thorley

    Hi Simon,

    How long have you been taking ARVs for? Do you have any other viral load results?

  10. simon

    Hi, my viral load is 2770. I’m taking my meds on time. I admit that for the past 3 months I was not using condom. But since the sisters at my clinic talked to me I’ve never engaged in sex.

Comment

Your email address will not be published. Required fields are marked *